Books

The dark side of motherhood

A psychiatrist explores mothers’ ambivalence over their needs and their children’s.

Poetry, paintings, and corporate America have long idealized the love of a mother for her child, from Kipling’s “Mother o’ Mine” to Mary Cassatt’s portraits and soft-focus Mother’s Day cards. Psychiatrist Barbara Almond, M.D. ’63, has written a new book about another aspect of motherhood: mothers’ feelings of anger and resentment.

Maternal ambivalence is both universal and inevitable, says Almond, a psychoanalyst, training analyst, and instructor emeritus in psychiatry at Stanford. In her book The Monster Within: The Hidden Side of Motherhood, Almond explores “the conflicts between the child’s and the mother’s needs, both legitimate.” Complicating these conflicts is the fear that accompanies love. “What we love can disappoint us. What we love, we can also lose,” Almond writes. “That mothers have mixed feelings about their children should come as no surprise to anybody, but it is amazing how much of a taboo the negative side of ambivalence carries in our culture.”

Almond draws on stories from clinical practice and fiction to investigate the dark side—from a woman’s commonplace fear that she will love her child insufficiently to extremes that include a mother’s murder of a daughter in Toni Morrison’s novel Beloved and Andrea Yates’s real-life drowning of her five children.

Almond contends that facing ambivalence, which she views as a mixture of loving and hateful feelings, can be constructive, “when it leads the mother to think creatively about her difficulties mothering and how they can be managed.”

Some publishers—and some reviewers—found Almond’s book too disturbing. On the contrary, she says, “I’m offering this as a comfort to mothers. They don’t have to drive themselves so hard.”

Bookshelf focuses on books and authors at the School of Medicine. Send suggestions to Cathy Shufro at cathy.shufro@yale.edu.

Book notes

How We Age: A Doctor’s Journey into the Heart of Growing Old

by Marc E. Agronin, M.D. ’91 (Da Capo Press) The author, a specialist in geriatric psychiatry, recounts his experiences counseling the residents of the Miami Jewish Home and Hospital, and describes how his work has transformed his view of aging. This book illustrates that aging is more than an inevitable decline—that old age can also be a period of vitality, wisdom, and creativity.

After the Diagnosis: Transcending Chronic Illness

by Julian Seifter, M.D., HS ’78, with Betsy Seifter, Ph.D. (Simon and Schuster) Julian Seifter had to learn to accept himself as a person with a lifelong illness when he was diagnosed with type 1 diabetes at the start of his intern year. In an account that is part memoir, part self-help book, the author speaks as both physician and patient, offering strategies helpful in managing chronic challenges on a day-to-day basis in order to maintain a positive and productive attitude toward life.

Envy Theory: Perspectives on the Psychology of Envy

by Frank J. Ninivaggi, M.D., FW 77, assistant clinical professor in the Child Study Center and of psychiatry (Rowman & Littlefield) The author offers a theory of envy as the nucleus of information processing. He explores various concepts related to envy as the root of mental disorders and treatment resistance as well as the possibility of turning envy into a tool for healthy maturation. He also advances principles and guidelines for pragmatic applications of his theory in psychotherapies and psychoeducation.

by John J. Huang, M.D., clinical instructor in medicine; and Paul A. Gaudio, M.D., assistant clinical professor of ophthalmology and visual science (Lippincott Williams & Wilkins) This clinical manual is designed for quick reference; it features color photographs along with bulleted how-to instructions for workup and treatment of each disorder. The book is organized into anterior, intermediate, and posterior eye disease, with separate sections for inflammation and infections of the cornea and sclera.

The Roots of the Recovery Movement in Psychiatry: Lessons Learned

by Larry Davidson, Ph.D., professor of psychiatry; Jaak Rakfeldt, Ph.D., assistant clinical professor of psychiatry; and John Strauss, M.D. ’59, professor emeritus of psychiatry (Wiley) The authors highlight the limitations of such previous efforts to reform and transform mental health practice as the deinstitutionalization movement begun in the 1950s, in the hope that the field will not repeat these mistakes. The book incorporates lessons about recovery gained from such related fields as psychology, sociology, social welfare, philosophy, political economic theory, and civil rights.

Probiotics: A Clinical Guide

by Martin H. Floch, M.D., clinical professor of medicine; and Adam S. Kim, M.D. (Slack) This guide presents current and evidence-based recommendations for primary care providers and gastroenterologists in the use of probiotics to treat specific diseases and disorders. It includes a review of the science underlying probiotics and probiotic products.

Handbook of Brain Microcircuits, 1st ed.

edited by Gordon Shepherd, M.D., D.Phil., professor of neurobiology; and Sten Grillner, M.D. (Oxford University Press) This handbook covers over 40 regions of the vertebrate and invertebrate nervous system to provide a guide to key circuits within the neurosciences. Each chapter is organized around wiring diagrams of the key circuits. The book includes a comprehensive presentation of a new concept of brain microcircuits as the major organizing principle of the nervous system.

Visualizing Psychology, 2nd ed.

by Siri Carpenter, Ph.D. ’00; and Karen Huffman, M.D.(Wiley) This book integrates updated photographs, illustrations, and graphics to elucidate complex concepts in psychology. The goal is to help students understand the world around them and interpret what they see in a meaningful and accurate way. Examples illustrate the uses of psychology in the workplace and personal relationships.

edited by Wasif Saif, M.D., M.B.B.S., associate professor of medicine (medical oncology) (Demos Medical Publishing) This text provides a review of current and emerging therapies for this group of malignancies, including common colorectal cancers, rare gastrointestinal stroma malignancies, and esophageal cancer. The chapters discuss current screening tools for colon cancers as well as assessment of predictive markers in the management of colon cancer. The volume also describes the state-of-the-art use of cytotoxic chemotherapy and the incorporation of newer biological therapies.

Seeing Patients: Unconscious Bias in Health Care

by Augustus A. White III, M.D., HS ’66 (Harvard University Press)In a book that is part autobiography, the author argues that the best means to improve health care is for medical schools to train physicians who are not only scientifically adept but also culturally competent. White cites studies showing that physicians and hospital staff on the whole dispense lower-quality care to minority patients. Females, both white and nonwhite, homosexuals, and the elderly are also treated differently from middle-class white men. Poorer quality of care results in measurably higher mortality rates among these vulnerable subpopulations.